title: Factors influencing health related quality of life in cancer patients with bone metastases.
abstract: OBJECTIVE
  Health related quality of life (HRQOL) is a multidimensional concept that is especially important for cancer patients with bone metastases, as maintaining and improving HRQOL is often the main focus of treatment. This study aims to determine factors that may influence HRQOL, which may in turn influence treatment and care of patients.
  
  
  METHODS
  Patients (n=396) completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) Bone Metastases module (BM22) at baseline. The EORTC QLQ-BM22 consists of four scales: painful site (PS), pain characteristics (PC), functional interference (FI), and psychosocial aspect (PA) scales. EORTC QLQ-BM22 data, together with sociodemographic and medical factors were analyzed by univariate analysis of variance (ANOVA). Items of significance were determined through backward selection, which were then put through multivariate analysis to determine further significance.
  
  
  RESULTS
  Through ANOVA analysis, KPS>80 and breast primary histology were predictive of better HRQOL in the PS scale, while KPS>80, female gender, and breast primary histology were predictive of better HRQOL in the PC and FI scales. KPS>80 and prostate primary histology were predictive of better HRQOL in the PA scale. KPS>80 and primary cancer site were confirmed as significant predictive factors in multivariate analysis.
  
  
  CONCLUSIONS
  This study identified baseline factors of gender, performance status, and primary histology as determinants of HRQOL in patients with bone metastases. Further study focusing on current treatment (chemotherapy, bisphosphonates, and radiotherapy) and spiritual well-being may identify additional factors affecting HRQOL. Understanding the influence of these factors will allow health care professionals to provide more effective palliative care.
authors.affiliation: Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Wong
authors.forename: Edward
authors.initials: E
authors.lastname: Chow
authors.forename: Liying
authors.initials: L
authors.lastname: Zhang
authors.forename: Gillian
authors.initials: G
authors.lastname: Bedard
authors.forename: Kinsey
authors.initials: K
authors.lastname: Lam
authors.forename: Alysa
authors.initials: A
authors.lastname: Fairchild
authors.forename: Vassilios
authors.initials: V
authors.lastname: Vassiliou
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Alm El-Din
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Jesus-Garcia
authors.forename: Aswin
authors.initials: A
authors.lastname: Kumar
authors.forename: Fabien
authors.initials: F
authors.lastname: Forges
authors.forename: Ling-Ming
authors.initials: LM
authors.lastname: Tseng
authors.forename: Ming-Feng
authors.initials: MF
authors.lastname: Hou
authors.forename: Wei-Chu
authors.initials: WC
authors.lastname: Chie
authors.forename: Andrew
authors.initials: A
authors.lastname: Bottomley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001859:Bone Neoplasms / Q000523:psychology* / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000473:pathology / Q000523:psychology*; D010166:Palliative Care / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology; D011788:Quality of Life; D012189:Retrospective Studies; D012737:Sex Factors; D018434:Sickness Impact Profile; D012944:Social Support; D029181:Spirituality; D011795:Surveys and Questionnaires